Sol Children Theatre Troupe

FALL SESSION OF CLASSES … Registration Form

STUDENT’S NAME____________________________________________________________

DATE OF BIRTH__________________________________ AGE________________________

PARENT’S (OR GUARDIAN’S) NAMES___________________________________________

HOME PHONE (____)______________PARENT’S CELL PHONE (____)_________________

BUSINESS PHONE (____)____________STUDENT’S CELL PHONE (____)_____________

MAILING ADDRESS___________________________________________________________

CITY___________________________________________ZIP CODE_____________________

PARENT’S EMAIL_____________________________________________________________

STUDENT’S EMAIL____________________________________________________________

ANY MEDICAL CONCERNS?____________________________________________________

I PREVIOUSLY TRAINED AT____________________________________________________

I WAS REFERRED BY__________________________________________________________

I UNDERSTAND THAT NON-REFUNDABLE FULL PAYMENT MUST BE MADE PRIOR TO STUDENT PARTICIPATING IN ANY CLASSES

....unless prior arrangements are made through the theatre office.

X  ______________________________________________Signature of Parent or Guardian

............................................................................................................................................................

FILL IN THE CLASS YOU ARE REGISTERING FOR:   FALL SESSION

TUESDAY:                             3:15             4:00             5:00

WEDNESDAY:             3:45             4:30             5:30

THURSDAY:                 3:30             4:30            

CLASSES/TEACHERS SUBJECT TO CHANGE WITH NOTIFICATION

Please mail or email to … or drop off at …

New Students … don’t forget $50 registration fee … tuition is due at first class

Sol Children Theatre Troupe Inc.  3333 North Federal Hwy.

Boca Raton, FL 33431           561-447-8829             SolChildTroupe@aol.com

www.solchildren.org

IF PAYING BY CREDIT CARD:

CIRCLE CARD TYPE:

AM EX            DISCOVER     MASTER CARD              VISA

TOTAL DOLLAR AMOUNT: _____________________________

CREDIT CARD NUMBER:________________________________

NAME as it appears on credit card:__________________________

FULL ADDRESS street, city, zip code:

_______________________________________________________

EXP. DATE:______                3 or 4 DIGIT SEC. CODE: ______ 

AUTHORIZING SIGNATURE:

_______________________________________________________